GRAY MATTERS: Home-delivered meals mean independence

Ina Harris is happy, in love and thankful for the hot meal that is delivered to her kitchen counter five days a week. The Humboldt Senior Resource Center's Home Delivered Meals Program makes it possible for Harris, 90, and her 94-year-old husband, Noel, to live independently in their Eureka home.

At 11:30 a.m. every weekday, holidays excluded, a volunteer driver from HSRC rings the Harris doorbell. It is always Ina who answers. Five years ago, a stroke stole Noel's mobility. Dementia chips away at his mind. His wife soldiers on, armed with a smile, quick wit and a bouquet of backyard flowers at the ready for visitors and drivers.

"We've been happily married for over 45 years and are still in love with each other," she said one December morning in her home. "It's been a pleasure to be his caregiver, but as we've gotten older, it's become more difficult for me to fix meals. I'm just so tired. I don't have the energy to even think about what we are going to have to eat."

Thanks to HSRC, she doesn't have to worry. Drivers, many of whom are volunteers and some of whom use their own cars, racked up 24,000 miles in the last fiscal year to deliver 44,242 meals to seniors who are generally homebound because of illness, disability or geographic isolation. Last year, 320 seniors living in the area from Trinidad to Fortuna received deliveries.

Menus are posted or mailed a month ahead of time -- Ina has hers taped on the side of the refrigerator -- and the pink slip for a donation comes with a recommended donation of $3.50 per meal.

"We are fine with whatever people choose to give. No one is denied," said Barbara Walser, director of Nutrition and Activities for HSRC. "It is more important to us that they have a nutritional meal."

"The meals have vegetables, meat, pasta, salad, dessert -- a great variety that's all prepared and very appetizing," Harris said. "All I have to do is put it in the microwave for our afternoon supper."

"There are seniors who are unable to cook, don't have enough money to buy nutritious food or don't know how to cook, and the ones who eat at our sites or get the meals delivered stay healthier and need less medical care because they are better nourished," said Debby Krzesni, the Area 1 Agency on Aging dietitian who works with HSRC and other sites to make sure the meals meet federal standards.

The home-delivered and site-based nutrition programs are covered under Title III of the 1965 Older Americans Act, which applies to people age 60 and older. But Walser said the mandated Senior Nutrition Program has never been fully-funded. An 11 percent decline in state and federal funding since 2005-06 and a 17 percent surge in gasoline costs have Walser and HSRC under constant pressure to raise money.

Walser said the local community always comes through, but raising almost $167,000 of a $429,000 program is not to be taken lightly.

"All sorts of stats out there show how important a nutritious meal is, especially for the frail people that can no longer make it to the congregate dining sites," Walser said. Hunger and malnutrition lead to multiple chronic diseases, decrease quality of life and increase the burden on long-term care and health insurance systems, Walser and Krzesni said.

"People are living longer and able to stay in their homes longer, in large part due to what for many is their only source of a healthy meal," Krzesni said. A study of more than 16,000 nursing homes done by a pair of Brown University researchers supports Krzensi. Published in the Health Services Research journal, statistical analysis from 2000 to 2009 shows that states that spent more than the average to deliver meals showed greater reductions in the proportion of nursing home residents who didn't need to be there.

The researchers call those who are not fully dependent "low care" residents, which in 2010 amounted to 12 percent of the nursing home population. Walser said the average cost of each home-delivered meal is $9.52, or about $210 per month. In comparison, the Genworth 2012 Cost of Care Survey puts the average monthly cost per person for assisted living in California at $2,900. The median price at the 95 surveyed facilities was $3,500.

That's still significantly less than skilled nursing homes, where the national average monthly cost for a shared room is $6,083 per person.

Walser joined the HSRC staff last summer. One of her first actions was to go into a home with a co-worker to determine the eligibility of a senior for the home delivery program.

"Her house was neat as a pin," Walser recalled. "We were going through the questions. Do you always have enough food in your house to eat? Are you able to buy all the food you need? She became very quiet. I could see the wheels turning. She was trying to answer, but it was like she was embarrassed to say."

Eventually, the woman said it was difficult to get out and buy groceries; that she sometimes ran out of food.

"It breaks your heart," Walser said. "What broke my heart the most is that she didn't want to tell us."

Proud, alone and struggling -- it made Walser think of what life would have been like for her father had her mom passed away first.

"Mom did the cooking and the shopping. Dad might push the cart, but he didn't have a clue. He would have eaten scrambled eggs the rest of his life," she said.

A third of home-delivered meal participants are male. Unlike Ina and Noel Harris, 61 percent of the local participants live alone.

"It's hard to get enthused about pouring a bowl of cereal or opening a can of soup," Walser said. "Then, there's the problem for someone who can't get to the store to buy either, or can't stand at the stove or counter long enough to prepare a meal or clean up afterwards."

"It would be very difficult without this meal," Harris said.

Life used to be different. Noel was a union business agent for Local 2931 and a history buff. She spent a decade as his secretary and was a member of the Human Rights Commission and active in the local branch of the NAACP.

When he retired at 62, she did so, too. The pair began a decade of college classes through Humboldt State's Over-60 program.

"I became a community activist and took journalism classes. He took history. The professors were glad to have him because he remembered the presidents the kids only read about," she said.

They competed to see who got the best grades -- Noel -- and they're still interested in politics and current events.

"We get the Times-Standard and read it cover to cover. Newsweek, too. I read books all the time," she said.

Home cooking is "hit or miss," as Ina describes it. By the time drivers Jim, Sandi or Nancy arrive, she's cleared a spot in front of the microwave for the meal. She welcomes the drivers with a "hug or whatever. They are such wonderful people, and it's such a wonderful program. I don't know how I'd do it otherwise."

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Area 1 Agency on Aging paid Carol Harrison to write this story. For more information on the home-delivered or congregate meal program, call HSRC at 443-9747 or A1AA at 442-3763.